Carbonic Anhydrase Inhibitors

This is a very powerful diuretic class but it only works for 3 days and it’s intended for hospital use only. They cause an increase in loss of carbonate in the urine and there’s an associated loss of sodium.

Therapeutic Uses

Short term diuretic effect: The reason it only works for three days is because as a person losse bicarbonate, the person becomes acidic. As a person becomes metabolically acidic, the lungs kick in by breathing faster! So then you get a compensatory respiratory alkalosis. So when that balance gets corrected, we no longer have diuresis.

Long term glaucoma: Another use is to lower intra-ocular pressure and this has an indefinite benefit and works for a long period of time (not limited to 3 days).

Toxicities

Drowsiness

Metabolic acidosis

Carbonic Anhydrase Inhibitors

These are easy to recognize because they all end in -zolamide.

Acetazolamide (Diamox) – p.o., inj.

Methazolamide (Neptazine) – p.o.

Dorzolamide (Trusopt) – ophthalmic drop. Preferred for glaucoma because it’s an eye drop and therefore has less systemic side effects.

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